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Confused as to how to proceed

Pusskins

Registered User
Jun 6, 2020
11
Hello. I have just joined this community. My husband has dementia. Twelve months ago he was almost normal, but now he is in a very bad way. His speech is confused although he still knows his surroundings, our pets and so on. My main concern is what is a good reason to place him into care? I would rather keep him at home as long as possible except that I am having problems with his personal hygiene. He is now refusing to let me give him a body bath and he refuses to allow a carer in to assist in this. He wears dentures, but hasn't cleaned them in months. He occasionally shaves and washes his hands. There is a dementia unit locally except that I don't like it and neither would he as it has a very small outdoor area. I have placed him on a waiting list at a dementia care home 40 minutes away by car, except that he is not familiar with this place. I am really struggling to know what to do. I have no family on hand and am doing this on my own.

My husband is not on any medication. He was prescribed Donepizil (?) but refuses to take it or any medication in general. He is 81.

My question is: Is there any way around the hygiene issues? Should I not worry about it and hope that eventually he will agree to me washing him or if not should he go into care?

Thank you for reading this.
 
Last edited:

TNJJ

Registered User
May 7, 2019
1,543
cornwall
Hello. I have just joined this community. My husband has dementia. Twelve months ago he was almost normal, but now he is in a very bad way. His speech is confused although he still knows his surroundings, our pets and so on. My main concern is what is a good reason to place him into care? I would rather keep him at home as long as possible except that I am having problems with his personal hygiene. He is now refusing to let me give him a body bath and he refuses to allow a carer in to assist in this. He wears dentures, but hasn't cleaned them in months. He occasionally shaves and washes his hands. There is a dementia unit locally except that I don't like it and neither would he as it has a very small outdoor area. I have placed him on a waiting list at a dementia care home 40 minutes away by car, except that he is not familiar with this place. I am really struggling to know what to do. I have no family on hand and am doing this on my own.

My husband is not on any medication. He was prescribed Donepizil (?) but refuses to take it or any medication in general. He is 81.

My question is: Is there any way around the hygiene issues? Should I not worry about it and hope that eventually he will agree to me washing him or if not should he go into care?

Thank you for reading this.
Hi. My dad is 87and has Vascular Dementia. He has not had a shower for over 6 months and his hair washed for over a month (He will let the carers wash him though.Dad cannot get in the shower.Poor mobility)..
A lot of(PWD) refuse to let a carer in at first as they think there is nothing wrong with them.When dad would not “allow”someone to do something as he was in control I went and organised it anyway.
Could you organise a carer to come in as a “cleaner” to help you. That would get him used to someone else.

It is entirely up to you if you wish to support your husband into a care home.Also if you are self funding you can organise it yourself. Or SS will do it if you are LA funded.
@Medication I have done it (covertly) so he doesn’t notice. But he would sometimes.
Dad will not take lactulose for the carers but will for me. I am blunt with him to be honest about why he needs it.
Does your husband have capacity?
 

Pusskins

Registered User
Jun 6, 2020
11
Hi. My dad is 87and has Vascular Dementia. He has not had a shower for over 6 months and his hair washed for over a month (He will let the carers wash him though.Dad cannot get in the shower.Poor mobility)..
A lot of(PWD) refuse to let a carer in at first as they think there is nothing wrong with them.When dad would not “allow”someone to do something as he was in control I went and organised it anyway.
Could you organise a carer to come in as a “cleaner” to help you. That would get him used to someone else.

It is entirely up to you if you wish to support your husband into a care home.Also if you are self funding you can organise it yourself. Or SS will do it if you are LA funded.
@Medication I have done it (covertly) so he doesn’t notice. But he would sometimes.
Dad will not take lactulose for the carers but will for me. I am blunt with him to be honest about why he needs it.
Does your husband have capacity?
Thank you for your response. No, my husband isn't really able to make decisions, but he's with it enough to know what he doesn't want. He can be very difficult and obstinate about things, but I do have access to home help/care assistants, so I will look into that.
 

canary

Registered User
Feb 25, 2014
12,659
South coast
he's with it enough to know what he doesn't want
Unfortunately, when asked if they want something the default answer of someone with dementia is usually no. As the dementia advances they find they cannot envisage what you are suggesting, cannot remember whether they have done this before, cannot work out whether they would like it and often cannot really understand what you are suggesting, so its much easier and safer to say no.

The answer, unfortunately, is to simply not ask them - just organise it and treat it as if they have already agreed to it. If you want to wait until they agree to something you may well wait forever.
 

Pusskins

Registered User
Jun 6, 2020
11
Unfortunately, when asked if they want something the default answer of someone with dementia is usually no. As the dementia advances they find they cannot envisage what you are suggesting, cannot remember whether they have done this before, cannot work out whether they would like it and often cannot really understand what you are suggesting, so its much easier and safer to say no.

The answer, unfortunately, is to simply not ask them - just organise it and treat it as if they have already agreed to it. If you want to wait until they agree to something you may well wait forever.
I tried having a care assistant come in to bath him in April. He got so angry that he was almost violent and adamantly refused to allow anybody else to wash him. He then grudgingly allowed me to do it. Since then I have only managed to get him to co-operate on a fortnightly basis. However, currently, we are 4 days past a fortnight and each day he refuses to let me wash him. I just don't know how to overcome this.
 

TNJJ

Registered User
May 7, 2019
1,543
cornwall
I tried having a care assistant come in to bath him in April. He got so angry that he was almost violent and adamantly refused to allow anybody else to wash him. He then grudgingly allowed me to do it. Since then I have only managed to get him to co-operate on a fortnightly basis. However, currently, we are 4 days past a fortnight and each day he refuses to let me wash him. I just don't know how to overcome this.
I either would let it go and try the carers with him.
Or would you be able to get in the shower with him(only if it is a wet room)
A bit random I know . I hope I haven’t upset you but I was thinking outside the box...So to speak.
 

lemonbalm

Registered User
May 21, 2018
303
Hello @Pusskins . My mum, now in a care home, screams and scratches if anyone tries to bath or shower her (she does that quite a lot anyway, unfortunately but this can be a trigger). Fear of water is quite common with people who have dementia. Have you tried using skin cleaning foam and no rinse shampoo foams?
 

canary

Registered User
Feb 25, 2014
12,659
South coast
Perhaps the carer could come and just chat to him to start with so that he gets to know them. Quite often carers know how to persuade people with dementia into showering - perhaps it was a clash of personalities.
OH was apprehensive when I first organised a carer to help him shower and dress, but now he has decided that he likes her. Perhaps Im just lucky, but I would try and find ways round it, because his hygiene is only going to get worse.
 

Weasell

Registered User
Oct 21, 2019
343
Do you have power of attorney?
The fees for his care will be about £62,000 a year. Will you be able to fund that or will you need to consult with social,services?
 

Weasell

Registered User
Oct 21, 2019
343
Do you have power of attorney?
The fees for his care will be about £62,000 a year. Will you be able to fund that or will you need to consult with social,services?
The reason I ask about funding is that if you will be looking to social services to fund any care you have less choices.
Sometimes, especially if you are on your own and everything seems overwhelming that can be easier.
So for example if you communicate your difficulties to social services they would not normally offer care home support, without trying alternatives first.
You tube has some short videos giving advice on personal care.
 

Pusskins

Registered User
Jun 6, 2020
11
I either would let it go and try the carers with him.
Or would you be able to get in the shower with him(only if it is a wet room)
A bit random I know . I hope I haven’t upset you but I was thinking outside the box...So to speak.
No, of course you haven't upset me! :) I've thought of it myself actually, but I think the water thing is the problem. Even when I have been able to wash him, I have to sit him on the bath seat and soap his body with his flannel, then gently rinse off with the portable shower head. he won't get into a shower. But lemonbalm above has suggested skin cleaning foam. I'd never heard of that, but it sounds really promising. My only other worry is that I wondered if it's not so much the water they're afraid of, but that their clothes are like a protective suit of armour to them, so they don't want to to take them off. I will have to try cleaning the top half while he's fully clothed from the waste down, then dress his top part and start on his nether regions. Not sure if any of it will work, but I'll have to give it a go at least.
 

Pusskins

Registered User
Jun 6, 2020
11
Perhaps the carer could come and just chat to him to start with so that he gets to know them. Quite often carers know how to persuade people with dementia into showering - perhaps it was a clash of personalities.
OH was apprehensive when I first organised a carer to help him shower and dress, but now he has decided that he likes her. Perhaps Im just lucky, but I would try and find ways round it, because his hygiene is only going to get worse.
That is a good idea. Something else to consider. Thank you. :)
 

Pusskins

Registered User
Jun 6, 2020
11
The reason I ask about funding is that if you will be looking to social services to fund any care you have less choices.
Sometimes, especially if you are on your own and everything seems overwhelming that can be easier.
So for example if you communicate your difficulties to social services they would not normally offer care home support, without trying alternatives first.
You tube has some short videos giving advice on personal care.
Yes, I have POA, but would have to apply through social services for funding.
 

Pusskins

Registered User
Jun 6, 2020
11
Hello @Pusskins . My mum, now in a care home, screams and scratches if anyone tries to bath or shower her (she does that quite a lot anyway, unfortunately but this can be a trigger). Fear of water is quite common with people who have dementia. Have you tried using skin cleaning foam and no rinse shampoo foams?
That is a very good idea! I'd never heard of skin cleansing foam, but I will definitely give it a try. No guarantee that it will change his obstinacy, but certainly worth trying. Thank you! :)
 

Pusskins

Registered User
Jun 6, 2020
11
The reason I ask about funding is that if you will be looking to social services to fund any care you have less choices.
Sometimes, especially if you are on your own and everything seems overwhelming that can be easier.
So for example if you communicate your difficulties to social services they would not normally offer care home support, without trying alternatives first.
You tube has some short videos giving advice on personal care.
Never thought of YouTube. Will look into that. Thank you. :)
 

lemonbalm

Registered User
May 21, 2018
303
That is a very good idea! I'd never heard of skin cleansing foam, but I will definitely give it a try. No guarantee that it will change his obstinacy, but certainly worth trying. Thank you! :)
Good luck. You can buy both on Amazon, by the way. I used to do mum's hair with a no rinse shampoo and she didn't mind it.
 

Weasell

Registered User
Oct 21, 2019
343
How tidal is his dementia? What I mean is are there times that you get the old him back for a while?
Could you pick a good time and try and find out if there is anything you can do to improve things.
Examples a special shower seat, support rails inside the shower, support rails when exiting the shower ?
I do my bit like in the film Jerry McGuire ‘ help me help you, help me help you’ !!!
 

Vic10

Registered User
Feb 18, 2017
130
You’ve already had some great advise on here. I would strongly endorse never asking the PWD because once they have said ‘no’ you’re stuck so just give it a go! Start small, a bit at a time, may be progress to top half then bottom half, great idea to then dress the bit that’s been done. I can’t get OH any where near the shower so it’s all done with flannels, mostly while he is sat on a chair with his feet in a soapy bowl!
Try not to stress about it,I used to and it got me nowhere!
I know OH is not having all over washes as often as I would like but we have made considerable albeit slow progress and we are coming to terms with a new normal!
 

Hazara8

Registered User
Apr 6, 2015
432
No, of course you haven't upset me! :) I've thought of it myself actually, but I think the water thing is the problem. Even when I have been able to wash him, I have to sit him on the bath seat and soap his body with his flannel, then gently rinse off with the portable shower head. he won't get into a shower. But lemonbalm above has suggested skin cleaning foam. I'd never heard of that, but it sounds really promising. My only other worry is that I wondered if it's not so much the water they're afraid of, but that their clothes are like a protective suit of armour to them, so they don't want to to take them off. I will have to try cleaning the top half while he's fully clothed from the waste down, then dress his top part and start on his nether regions. Not sure if any of it will work, but I'll have to give it a go at least.
Water takes on a very different role in dementia, especially water on the head. Each case is different. But washing whilst still clothed is not uncommon as you suggest. Once the washing is done, then there will be probably a desire to remove the wet things without any fuss. Distraction or humor can assist in these situations, but one thing remains set in stone, do NOT argue ever. Dementia just simply cannot comprehend your demands, however well intended. Sometimes simply acting in a routine manner without any obvious changes in procedure can help. Less is more so to speak. At the end of the day everyone is different and trial and error becomes the watchword. If Carers prove successful because they are ' removed ' and thus communicate a sense of calm, all to the good. None of this is at all easy and each day can surprise when least expected. A positive approach often reaps rewards as does say a warm flannel placed on hands. Hygiene being important necessitates perseverance. On here, there are many folk who can suggest an approach or a proven way to alleviate the angst. But as every single case is different it remains a personal challenge in essence and yet not a hopeless one.
 

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